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Am J Med. 2004 Dec 15;117(12):925-31.

Beta-blockers as single-agent therapy for hypertension and the risk of mortality among patients with chronic obstructive pulmonary disease.

Author information

  • 1Health Services Research and Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, Washington 98108, USA. dau@u.washington.edu

Abstract

PURPOSE:

To assess the association between the type of antihypertensive medication and all-cause mortality among patients with chronic obstructive pulmonary disease (COPD).

METHODS:

The cohort comprised 1966 patients (mean [+/- SD] age, 65.8 +/- 10.7 years) enrolled in general internal medicine clinics at seven Veterans Affairs medical centers between December 1996 and October 1999. Patients had a diagnosis of both COPD and hypertension and were receiving single-agent antihypertensive therapy.

RESULTS:

Compared with calcium channel blockers, beta-blockers were associated with a decrease in mortality from any cause after adjusting for propensity for having been prescribed a beta-blocker (hazard ratio = 0.57; 95% confidence interval: 0.33 to 0.89). The association was similar when beta-blockers were compared with all other antihypertensive medications, and the decreased risk of mortality was apparent among patients with pre-existing cardiac disease. Restriction of analyses to long-acting calcium channel blockers or to patients who used beta-agonists did not affect the point estimates. Exposure to the remaining classes of antihypertensive agents was not associated with mortality.

CONCLUSION:

Beta-blockers may have beneficial effects in patients who have COPD, pre-existing cardiac disease, and hypertension. Beta-blockers may not be contraindicated among patients with COPD.

PMID:
15629731
DOI:
10.1016/j.amjmed.2004.07.043
[PubMed - indexed for MEDLINE]
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